Trauma severity scoring systems are routinely used to monitor trauma patient outcomes. Yet, the most accurate scoring system remains an elusive target.
We aim to compare trauma severity scales (ISS, NISS, RTS, TRISS, and BIG) in multitrauma patients and investigate BIG as one of the new trauma severity scoring systems.
The demographic data of the patients, vital signs, injury mechanisms, body regions exposed to trauma, final diagnosis, the injury severity scales-Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), base deficit, international normalized ratio, and Glasgow Coma Scale (BIG), and Trauma and Injury Severity Score (TRISS)-the length of stay in hospital, and the progress of the patients were examined.
A total of 426 cases were included in the study. The best performing score in determining mortality was TRISS (area under the curve [AUC] 0.93, sensitivity 97.1% and specificity 76.7%). This was followed by the NISS, BIG, ISS, and RTS, respectively. For the prediction of intensive care unit admission, the NISS was the most successful with an AUC value of 0.81. There was a significant relationship in terms of the length of stay in all trauma scores (p &lt; .05).
The most successful score in predicting mortality in trauma patients was the TRISS, whereas the NISS was the most successful in predicting intensive care unit admission. The newly developed BIG score can be used as a strong scoring method for predicting prognosis in trauma patients.
The most successful score in predicting mortality in trauma patients was the TRISS, whereas the NISS was the most successful in predicting intensive care unit admission. The newly developed BIG score can be used as a strong scoring method for predicting prognosis in trauma patients.Few studies have tracked hand injury patients past the acute care period. Postdischarge tracking of hand injury patients may identify time points most patients require assistance, which can help direct interventions to reduce post-hand injury sequelae.
To examine hand injury patients' experiences during early recovery to illness perceptions, disabilities, and quality of life and to identify predictors of quality of life at 1 month and 3 months after hospital discharge.
This prospective observational study of hand injury patients was performed at a teaching hospital in Taiwan. https://www.selleckchem.com/ Data were collected at patient discharge, 1 month, and 3 months after discharge, from January 2017 to October 2018. The variables measured included illness perceptions, disabilities, and quality of life.
A total of 117 patients participated in the study. The patients reported more positive illness perceptions at 3 months versus 1 month after discharge. The impact of disabilities on patient work was significantly greater at 1 month than at 3 months after discharge. Quality of life was better at 3 months than at 1 month after discharge. Predictors of quality of life after hospital discharge were demographic variables, clinical variables, and illness perceptions. Patients with lower education reported poorer psychological quality of life after discharge.
Primary care providers should perform a comprehensive assessment of patients prior to their discharge. Patients should undergo regular follow-ups to reduce comorbidities and improve their outcomes.
Primary care providers should perform a comprehensive assessment of patients prior to their discharge. Patients should undergo regular follow-ups to reduce comorbidities and improve their outcomes.Trauma patterns in adults are influenced by weather conditions, lunar phases, and time of year. The extent to which these factors contribute to pediatric trauma is unclear.
The present study aimed to review patients from a single Level I pediatric trauma center to determine the influence of weather, the lunar cycle, and time of year on trauma activity.
A retrospective review of trauma activations (n = 1,932) was conducted from 2015 to 2017. Injury type and general demographics were collected. Weather data and lunar cycles were derived from historical databases.
Days with no precipitation increased the total number of injuries of all types compared with those with precipitation (p &lt; .001). Blunt and penetrating injuries were more likely to occur during full moons, whereas burn injuries were significantly higher during new moons (p &lt; .001). Blunt trauma was significantly higher in September than all other months, F(11, 1,921) = 4.25, p &lt; .001, whereas January had a significantly higher number of burns than all other months (p &lt; .001).
Pediatric trauma trends associated with external factors such as weather, lunar cycles, and time of year can inform hospital staffing decisions in anticipation of likely injuries and help direct injury prevention efforts.
Pediatric trauma trends associated with external factors such as weather, lunar cycles, and time of year can inform hospital staffing decisions in anticipation of likely injuries and help direct injury prevention efforts.Motor vehicle (MVCs) and motorcycle crashes (MCCs) continue to be among the most prevalent mechanisms of trauma injury and mortality. We sought to identify specific populations and factors associated with MVCs and MCCs for local injury prevention efforts. A novel, yet easily performed, research method was utilized-a qualitative content analysis of text narratives describing each patient's cause of injury.
To determine target populations for local MVC and MCC injury prevention.
A retrospective descriptive analysis was performed using registry data from a Level I trauma center. The registry was queried for all trauma patients presenting with MVC or MCC injuries between June 8, 2014, and June 7, 2019. Cases were then reviewed via their respective text narratives of injury causation. Common themes were identified, coded by independent raters, and assessed for interrater reliability using Cohen's κ. Frequencies and proportions are reported for each preventable factor and patient characteristic.
There were a total of 2,861 cases studied, of which 2,330 (81.4%) were MVC and 531 (18.6%) were MCC. Demographics varied by mechanism of injury. Driver drug or alcohol use was involved in 97 (3.4%), protective devices were not used in 776 (27.1%), distracted driving was involved in 30 (1%), excessive speeding was involved in 152 (5.3%), and driver sleeping/syncope/medical condition was present in 113 (3.9%) cases.
Content analysis of cause of injury text narratives can detect target populations and preventable factors to direct injury prevention efforts specific to the local population.
Content analysis of cause of injury text narratives can detect target populations and preventable factors to direct injury prevention efforts specific to the local population.